Individual provider Active NPI

Moira P Ripley, PSY.D.

  • Clinical Psychologist
  • Lebanon, NH
National Provider Identifier
1528098456
Registry record updated Feb 28, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
1076 Issued in NH
Practice address
1 Court St
Suite 330
Lebanon, NH 03766-1358
Phone
(603) 442-9393
Fax
(603) 442-9393
NPI assigned
Jul 4, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 28, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 048-852 VT
Clinical Psychologist 103TC0700X 1076 NH Primary

Addresses

Primary practice location

1 Court St
Suite 330
Lebanon, NH 03766-1358

Mailing address

1 Court St
Suite 330
Lebanon, NH 03766-1358
Phone (603) 442-9393

Other identifiers 4

IdentifierTypeStateIssuer
789467000OtherVTMAGELLAN PROVIDER NUMBER
06Y008268VT01OtherNHANTHEM BCBS PROVIDER NUMB
00068590OtherVTBCBSVT PROVIDER NUMBER
1011090MedicaidVT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090120000267 NH Practitioner - Clinical Psychologist 9032297940 Practice locations: Lebanon, NH

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1 Court St
Suite 330
Lebanon, NH 03766-1323
Phone (603) 442-9393

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1076NHMDMental Health Counselor
048-852VTMDClinical Psychologist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1151971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1425081600000",
    "number": "1528098456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 COURT ST",
            "address_2": "SUITE 330",
            "city": "LEBANON",
            "state": "NH",
            "postal_code": "037661358",
            "telephone_number": "603-442-9393",
            "fax_number": "603-442-9393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 COURT ST",
            "address_2": "SUITE 330",
            "city": "LEBANON",
            "state": "NH",
            "postal_code": "037661358",
            "telephone_number": "603-442-9393",
            "fax_number": "603-442-9393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIPLEY",
        "first_name": "MOIRA",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-04",
        "last_updated": "2015-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "VT",
            "license": "048-852",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NH",
            "license": "1076",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN PROVIDER NUMBER",
            "identifier": "789467000",
            "state": "VT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS PROVIDER NUMB",
            "identifier": "06Y008268VT01",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSVT PROVIDER NUMBER",
            "identifier": "00068590",
            "state": "VT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1011090",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lebanon, NH

Sources for this page

Verify at the official NPI Registry.